Regional cortical and trabecular bone loss after spinal cord injury

Shauna Dudley-Javoroski; Richard K Shields

doi:10.1682/JRRD.2011.12.0245

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Regional cortical and trabecular bone loss after spinal cord injury

Journal article

Open access

Peer reviewed

Regional cortical and trabecular bone loss after spinal cord injury

Shauna Dudley-Javoroski and Richard K Shields

Journal of rehabilitation research and development, Vol.49(9), pp.1365-1376

2012

DOI: 10.1682/JRRD.2011.12.0245

PMCID: PMC3647247

PMID: 23408218

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Abstract

Spinal cord injury (SCI) triggers rapid loss of trabecular bone mineral density (BMD) in bone epiphyses and a loss of cortical cross-sectional area (CSA) in bone diaphyses, increasing fracture risk for people with SCI. The purpose of this study was to measure trabecular BMD and cortical CSA loss at several previously unexamined lower-limb sites (4% fibula, 12% femur, 86% tibia, cortical) in individuals with SCI. Using peripheral quantitative computed tomography, we scanned 13 participants with SCI longitudinally and 16 on one occasion; 21 participants without SCI served as controls. In the first year post-SCI, 15% to 35% of BMD was lost at the distal femur, proximal tibia, and distal fibula. Bone loss at the distal fibula accelerated between 1 and 2 years post-SCI. BMD at these sites reached a steady state value of ~50% of the non-SCI value 4 years post-SCI. At the tibia diaphysis, cortical CSA decline was slower, eventually reaching 65% of the non-SCI value. Because of the extensive loss of bone observed at these sites, careful consideration needs to be given to the dose of musculoskeletal stress delivered during rehabilitation interventions like standing, muscle electrical stimulation, and aggressive stretching of spastic muscles.

Spinal Cord Injuries - complications

Humans

Middle Aged

Male

Tomography, X-Ray Computed

Femur - diagnostic imaging

Case-Control Studies

Young Adult

Time Factors

Epiphyses - physiopathology

Adult

Female

Tibia - physiopathology

Bone Resorption - etiology

Cervical Vertebrae

Epiphyses - diagnostic imaging

Fibula - physiopathology

Bone Density

Diaphyses - diagnostic imaging

Tibia - diagnostic imaging

Femur - physiopathology

Fibula - diagnostic imaging

Analysis of Variance

Thoracic Vertebrae

Diaphyses - physiopathology

Adolescent

Spinal Cord Injuries - rehabilitation

Aged

Details

Title: Subtitle: Regional cortical and trabecular bone loss after spinal cord injury
Creators: Shauna Dudley-Javoroski - Physical Therapy and Rehabilitation Science, Carver College of Medicine, The University of Iowa, Iowa City, IA 52242, USA
Richard K Shields
Resource Type: Journal article
Publication Details: Journal of rehabilitation research and development, Vol.49(9), pp.1365-1376
DOI: 10.1682/JRRD.2011.12.0245
PMID: 23408218
PMCID: PMC3647247
NLM abbreviation: J Rehabil Res Dev
ISSN: 0748-7711
eISSN: 1938-1352
Publisher: United States
Grant note: R01 NR010285 / NINR NIH HHS R01NR010285 / NINR NIH HHS R01HD062507 / NICHD NIH HHS R01 HD062507 / NICHD NIH HHS
Language: English
Date published: 2012
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9984046824102771

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